Healthcare Reform Through the Lens of Community Mental Health

Obama’s primetime speech, his Sunday morning interview extravaganza, and the loads of resistance he and other health care reformers are receiving has me thinking about my own life as it relates to the subject. I’m not referring to the benefits of my own health insurance coverage, or lack thereof. My thoughts have focused on my role as a psychological trainee at a San Francisco community mental health center.

As a clinical psychological doctoral student, I spend two days a week in a training practicum. Over the last year and a half of my practicum experience I’ve seen, with an intimate perspective, how our current health care system has been less than solid, less than efficient, and providing less than satisfactory services. I have been witness to individuals who suffer from some of the most debilitating mental health conditions such as Schizophrenia, Bipolar Disorder, and Major Depressive Disorder. Although on paper we have the resources to fully address their needs, due to city budget shortfalls, staff shortages, limited physical space, individuals seeking services are often turned away or told to come back in a couple of weeks. For some, waiting two weeks or more will mean dramatic deterioration and risk of serious and permanent impairments.

I realize these days other U.S. city’s are not devoid of similar situations. This means that unfortunate circumstances described above are occurring in various metropolitan settings. What will happen if local budget cuts continue to pass and federal health care reform is delayed or even desecrated through political compromise? Serving often-disenfranchised individuals with mental illness will continually be difficult taking immense efforts to provide ethically sound and satisfactory service.

One piece of good news received this week outlines a continued Medicare coverage for psychotherapy, which is at the heart of what I do in my day-to-day clinic life. Below you will find a news release regarding this legislation. The hope is that this will not be an anomaly but will be the norm for future mental health coverage for our country’s most vulnerable.

“Today Senate Finance Committee Chairman Max Baucus (D-MT) released an outline of his long-awaited health care reform bill, which includes Medicare provisions. I am pleased to inform you that the America’s Healthy Future Act is set to include psychology’s top Medicare priority – a two-year extension of the 5% psychology payment restoration previously passed as part of the Medicare Improvements for Patients and Providers Act (MIPPA) in 2008. This important victory follows action in the House earlier this summer, where the three committees of jurisdiction passed bills that also included the provision. The extension would ensure that approximately $60 million will continue to support Medicare psychotherapy services that would otherwise have been cut as a result of the Centers for Medicare and Medicaid Services (CMS) five-year review rule.”

--- Marilyn Richmond, J.D., Assistant Executive Director for Government Relations, American Psychological Association